Objective:To observe and analyze the function of intestinal barrier in patients with pouchitis, and to explore the role of nucleotide oligomerization domain 2 (NOD2) in ileal pouchitis, so as to provide new ideas for the pathogenesis of pouchitis.Methods:From January 2011 to December 2016, the clinical pathological data of patients with ileal pouch-anal anastomosis who underwent pouch mucosa biopsy at the Endoscopy Center of General Hospital of Tianjin Medical University were retrospectively analyzed. According to the disease activity index of pouchitis, patients were divided into pouchitis group (20 cases) and non-pouchitis group (30 cases). In addition, UC patients who did not undergo surgery were selected as the control group (10 cases). The intestinal structure of patients of the pouchitis group and non-pouchitis group was observed under transmission electron microscope. The positive expression rates of occludin, alpha human defensin and NOD2 in the control group, non-pouchitis group and pouchitis group were detected and calculated by immunohistochemistry. Levene test, independent sample t test and Spearman correlation analysis were used for statistical analysis. Results:Under the transmission electron microscope, the tight junction epithelial structure and microvilli of intestinal mucosal of patients in the pouchitis group were severely injured. The results of immunohistochemistry showed that the positive expression rates of occludin, alpha human defensin and NOD2 in the intestinal mucosa of patients in the pouchitis group were all lower than those of the control group and non-pouchitis groups ((19.3±0.4)% vs. (84.0±0.3)% and (77.9±0.5)%; (60.0±1.3)% vs. (85.0±0.1)% and (77.3±0.4)%; (46.1±1.6)% vs. (72.0±0.7)% and (60.7±0.5)%), and the differences were statistically significant ( t=-8.451, -7.514, -3.943, -2.970, -5.115 and -2.982, all P<0.05). The correlation analysis showed that the expression level of NOD2 was positively correlated with occludin and alpha human defensin ( r=0.671 and 0.628, both P<0.01). Conclusions:Intestinal barrier function is impaired in patients with ileal pouchitis, and NOD2-related intestinal barrier injury may play an important role in the pathogenesis of ileal pouchitis.

Objective: To understand the incidence of school bullying and its influencing factors among adolescents in low-income and middle-income countries, and to explore the association between school bullying and mental health of adolescent students, so as to provide reference for prevention and control of school bullying and mental health intervention. Methods: Data was obtained from the 2009-2015 Global School Student Health Survey from 19 low-income and middle-income countries (n=22 963). Binary Logistic regression was used to analyze the influencing factors of school bullying, and multiple linear regression was used to analyze the relationship between school bullying and mental health. Results: The average score of students mental health was(5.75±2.09), and approximately 35.1% of adolescent students reported suffering from school bullying. The rates of school bullying among students in low-income and middle-income countries were 39.4% amd 34.3%, respectively. Students with lower grades, overweight, poor family economic status, low family learning and psychological support, poor perceived family relationship, more truancy, and poor relationship with classmates were more likely to suffer from school bullying(P<0.05). Exposure to school bullying was positively associated with adverse mental health outcomes for women(B=1.27, P<0.01). Conclusion Not only were school bullying more common in low-income countries, but also school bullying had a greater negative impact on the mental health of girls. We need to pay more attention to school bullying among adolescent students, especially in low-income countries and girls, with cost-effective interventions to reduce or mitigate the consequences of bullying.

Objective: To analyze the clinical data of 153 patients with novel coronavirus pneumonia (COVID-19) in chongqing ,and provide reference and thinking for the diagnosis and treatment. Methods: Analyze the clinical data, laboratory examination and chest imaging characteristics of 153 COVID-19 patients in Chongqing Public Health Medical Center from January 26 to February 5, 2020. According to the relevant diagnostic criteria ,patients were divided into non-severe group(n=132) and severe group(n=21),and analyze the correlation between serum index changes and disease severity. Results: Combined with diabetes and chronic respiratory diseases, the severity of the disease was statistically significant (χ²=11.04和6.94, P<0.05). No symptoms were found in patients with mild illness (χ²=4.09, P<0.05) .The proportion of fever and muscle soreness in the severe group was higher than that in the non-severe group (χ²=4.40 and 22.67,P<0.05).Among the concomitant symptoms, the proportion of cough and shortness of breath in the severe group was higher than that in the non-severe group (χ²=8.46 and 4.80,P<0.05).C-reactive protein and d-dimer were higher in the severe group than in the non-severe group (t=43.44 and 37.13, P<0.05), and the number of CD₃⁺T lymphocyte cells, CD₄⁺T lymphocyte cells and CD₈⁺T lymphocyte cells in the severe group was lower than that in the non-severe group (Z=27.25, 20.60 and 17.36, P<0.05).Compared with the non-severe group, both lungs and the right lung lower lobe were more susceptible to involved (χ²=6.95和20.39, P<0.05) . Conclusion Severity of COVID-19 was associated with underlying disease, symptoms, site of involvement, C-reactive protein, d-dimer, CD₃⁺T lymphocyte count, CD₄⁺T lymphocyte count, and CD₈⁺T lymphocyte count. 

BACKGROUND:As the high proliferation and low apoptosis of the bone marrow in polycythemia vera patients, hematopoietic stem cels transplanted into NOD/SCID mice can differentiate into erythroid cels, but whether hematopoietic stem cels transplantation could improve the hematopoietic function of aplastic anemia mice is not yet reported. OBJECTIVE:To investigate whether transplantation of bone marrow mononuclear cels with JAK2V617F mutation from polycythemia vera patients can influence hematopoietic reconstruction in aplastic anemia mice. METHODS:Severe aplastic anemia mouse models were established by using recombinant human interferon-γplus busulfan, and then, these mouse models were randomly divided into experimental group (n=10) and control group (n=10). Bone marrow mononuclear cels isolated from polycythemia vera patients with positive JAK2V617F mutation were transplanted into the mice in the experimental group via tail vein at 5 days after drug withdrawal.The same volume of normal saline was administered to the control group. Routine peripheral blood test, morphology of bone marrow cels, bone marrow biopsy, and percentage of CD45+ cels in the peripheral blood and marrow were determined at 14 days after transplantation. RESULTS AND CONCLUSION: At 14 days after transplantation, pancytopenia occurred in the experimental group, bone marrow smears showed scattered lymphocytes and hematopoietic progenitors, and bone marrow biopsy presented that hematopoietic tissues were reduced and a smal amount of granulocyte cels and erythroblasts could be seen, but megakaryocytes were rare. In contrast to the control group, there was no improvement in the hematopoietic function of mice in the experimental group. CD45+ cels were detectable in the peripheral blood and bone marrow in the experimental group, but not in the control group; and a higher percentage of CD45+ cels was measured in the bone marrow than in the peripheral blood of experimental group mice. Experimental findings indicate that bone marrow mononuclear cels from polycythemia vera patients with positive JAK2V617F mutation can be engrafted into aplastic anemia mice, but cannot improve the hematopoietic function of mice.

Objective:To analyze the clinical features of patients with COVID-19 in Chongqing Municipality.Methods:The clinical data, laboratory tests and chest imaging findings of 153 patients COVID-19 admitted in Chongqing Public Health Medical Center from January 26 to February 5, 2020 were retrospectively reviewed. According to the relevant diagnostic criteria, patients were divided into non-severe group (n=132) and severe group (n=21). The correlation between serum index changes and disease severity was analyzed.Results:The proportion of patients with underlying diabetes or chronic respiratory diseases in severe group was significantly higher than that in non-severe group ( χ2=11.04 and 6.94, P<0.05). The proportion of symptom-free patients in non-severe group was significantly higher than that in severe group ( χ2=4.09, P<0.05). The symptoms of fever, fatigue and muscle soreness in the severe group were more common than those in the non-severe group ( χ2=4.40, 14.42 and 22.67, P<0.05). Among the concomitant symptoms, the proportion of cough and shortness of breath in the severe group was higher than that in the non-severe group ( χ2=8.46 and 4.80, P<0.05). C-reactive protein and D-Dimer levels were higher in the severe group than those in the non-severe group ( Z=-4.39 and -1.96, P<0.05), and the number of CD3 + T lymphocyte cells, CD4 + T lymphocyte cells and CD8 + T lymphocyte cells in the severe group was lower than that in the non-severe group ( Z=27.25, 20.60 and 17.36, P<0.05). Compared with the non-severe group, both lungs and the right lung lower lobe were more susceptible to be involved( χ2=9.71和23.61, P<0.05). Conclusions:There are significant differences in underlying diseases, clinical symptoms, imaging manifestations and laboratory findings between severe and non-severe patients with COVID-19.

Objective:To study the clinical and genetic features of neonatal Smith-Kingsmore syndrome (SKS).Methods:The clinical data of a newborn with SKS admitted to our hospital in November 2021 were reviewed. Using "Smith-Kingsmore", "rapamycin gene", "newborn", "premature infant", "the mammalian target of rapamycin", "MTOR", "mTOR", "Smith-Kingsmore syndrome", "megalencephaly", "macrocephaly" and "hemimegalencephaly" as keywords, databases including CNKI, Wanfang Database, VIP database, PubMed, Embase, Web of Science and the Cochrane Library were searched from the date of establishment to January 1, 2022. The clinical and genetic features of neonatal SKS from published literature were summarized.Results:The case admitted to our hospital was a male preterm infant. The presenting symptoms were groan and hypotonia. The facial abnormalities included macrocrania, ocular hypertelorism, depressed nasal bridge and low-set ears. Brain MRI showed lateral ventricle enlargement. Whole-genome sequencing (WGS) showed mTOR gene nonsense heterozygous mutation (NM_004958.4:c.7255G>A:p.Glu2419Lys). Neither father nor mother had any pathogenic gene mutations. The infant had seizure at 2-month and phenobarbital was effective reducing seizure. Gross motor delay was present at 3-month. Sixteen related articles were retrieved, including eight articles with 10 neonatal cases. Among them, 6 cases were male. The main clinical features were megalencephaly or hemimegalencephaly (9/10), facial developmental malformation (8/10), hypotonia (6/10), large-for-gestational age (LGA) infants (5/10), cerebral ventricle dilation (4/10) and abnormal corpus callosum (4/10). All the gene mutations were missense mutations, including c.5395G>A(p.Glu1799Lys) mutation in 5 cases, c.4448G>T(p.Cys1483Phe) mutation in 1 case, c.4448G>T(p.Cys1483Tyr) mutation in 1 case, c.7235A>T(p.Asp2412Val) mutation in 1 case, c.5663T>G(p.Phe1888Cys) mutation in 1 case, c.5390C>T(p.Thr1799IIe) mutation in 1 case.Conclusions:The clinical phenotypes of neonatal SKS are diverse, including megalencephaly, facial malformation, LGA and hypotonia. The brain MR findings included (hemi) megalencephaly, cerebral ventricle dilation and corpus callosum hypoplasia. Most of the gene mutations are missense mutations and c.5395G>A(p.Glu1799Lys) is the hotspot.

Objective:To analyze the current situation and influencing factors of family economic burden in children with congeni-tal heart disease,and provide reference basis for relevant departments.Methods:Conduct a questionnaire survey on the parents of children with congenital heart disease,and use a multiple linear regression model to analyze the factors affecting the economic bur-den of the disease.Results:The median total economic burden of families with congenital heart disease is 44 140 yuan,which is higher than the average level of per capita disposable income among residents of Xinjiang from 2020-2022.The median direct non-medical economic burden is 2 700 yuan,and the median indirect economic burden is 2 890 yuan.The length of hospital stay and monthly household income are important factors affecting the total economic burden.Conclusion:The total economic burden of families with congenital heart disease is higher than the per capita disposable income.The more complex the condition,the longer the days of hospitalization and the longer the time lost from work,resulting in a higher overall financial burden.

Objective: : Blood-blister aneurysms (BBAs) of the internal carotid artery (ICA) are challenging lesions with high morbidity and mortality rates. Although research on BBAs is well documented in different populations, the study of BBAs in the Tibetan population is extremely rare. This study aimed to evaluate the characteristics of BBAs and analyze the treatment modalities and long-term outcomes in the Tibetan population in comparison with the Han population. Methods: : The characteristics of patients with BBAs of the ICA from January 2009 to January 2021 at our institution were reviewed. The features of aneurysms, treatment modalities, complications, and follow-up outcomes were retrospectively analyzed. Results: : A total of 130 patients (41 Tibetan and 89 Han patients) with BBAs of the ICA who underwent treatment were enrolled. Compared with the Han group, the Tibetan group significantly demonstrated a high ratio of BBAs among ICAs (8.6%, 41/477 vs. 1.6%, 89/5563; p<0.05), a high ratio of vasospasm (34.1%, 14/41 vs. 6.7%, 6/89; p=0.001), a high risk of ischemic events (43.9%, 18/41 vs. 22.5%, 20/89; p<0.05), and a low ratio of good outcomes (modified Rankin scale, 0–2) at the 1-year follow-up (51.2%, 21/41 vs. 74.2%, 66/89; p<0.05). The multivariate regression model showed that ischemic events significantly contributed to the prediction of outcomes at 1 year. Further analysis revealed that microsurgery and vasospasm were associated with ischemic events. Conclusion : In comparison with Han patients, the Tibetan population had a high ratio of BBA occurrence, a high incidence of ischemic events, and a high ratio of poor outcomes. The endovascular approach showed more benefits in BBA patients.

Objective To systematic review the influence of case-based payment on inpatient costs since China′s new medical reform. Methods Studies about inpatient costs before and after the implementation of case-based payment were collected. The literature collected underwent a meta-analysis by RevMan 5. 0. Results A total of 11 articles in compliance were included in the study. The meta-analysis of random effect model showed the overall effect size (SMD) was -1. 54 with 95% CI being -1. 79, -1. 29, showing a significant difference (P<0. 05). The subgroup analysis showed that the overall effect size (MD) in the low-cost disease group was -585. 57 yuan with 95% CI being -750. 34, -420. 80, showing a significant difference (P < 0. 05). The overall effect size (MD) in the high-cost disease group was-4 172.65 yuan with 95% CI being -5 368. 21, -2 977. 10, showing a significant difference ( P <0.05). The funnel plot was approximately symmetrical, suggesting a publication bias as less likely in the study. Conclusions The implementation of case-based payment has reduced the inpatient costs to some extent thanks to China′s new healthcare reform. And the effect in the high-cost disease group was more obvious than that in the low-cost disease group.

【Objective】 To explore the application value of ¹⁸F-PSMA PET/CT on the detection of metastatic lesions of prostate cancer with serum total prostate specific antigen (tPSA) ≤20 ng/mL and the predictive variables affecting the imaging results, and to establish a predictive nomogram for the metastasis of prostate cancer. 【Methods】 The imaging, pathological, serum and clinical data of 175 pathologically confirmed prostate cancer patients who underwent ¹⁸F-PSMA PET/CT examination during Jan.2020 and Oct.2021 were retrospectively collected.The patients were divided into metastatic group and non-metastatic group according to PET/CT imaging results, and the positive detection rate of metastatic lesions was calculated.The independent influencing factors of ¹⁸F-PSMA PET/CT in the positive detection of metastatic lesions were determined with univariate and multivariate logistic regression analyses.The predictive nomogram was established. 【Results】 Of the 175 patients, metastatic lesions were detected in 78 cases and not detected in 97 cases, with a detection rate of 44.6% (78/175).There were statistically significant differences between the metastatic group and the non-metastatic group in urinary tract symptoms, androgen deprivation treatment (ADT) at the time of PET/CT examination and the risk level of Gleason score (GS) (P<0.05).Univariate logistic regression showed that urinary tract symptoms(OR=3.64, P<0.001), GS risk (OR=3.96, P<0.001) and concurrent ADT treatment (OR=3.71, P<0.001) were associated with the positive detection rate of metastatic lesions.Multivariate Logistic regression showed that urinary tract symptoms (OR=3.19, P=0.002), GS high-risk group (OR=2.95, P=0.005) and concurrent ADT treatment (OR=3.27, P=0.001) were independent predictors of positive detection rate. 【Conclusion】 The probability of metastasis in newly diagnosed prostate cancer patients with tPSA≤20 ng/mL is high.¹⁸F-PSMA PET/CT is of high value for the early detection of metastasis.Urinary tract symptoms, GS high-risk group and concurrent ADT treatment are independent predictors of metastatic lesions.The predictive nomogram can help assist clinical optimization of imaging examination path.